Robert Reich: What We Need is Medicare for All

As Republicans in Congress move to repeal the Affordable Care Act, Democrats are moving toward Medicare for All – a single-payer plan that builds on Medicare and would cover everyone at far lower cost.

With health care emerging as the public’s top concern, according to recent polls, the choice between repeal of the Affordable Care Act and Medicare for All is likely to be the major domestic issue in the presidential campaign of 2020 (other than getting Trump out of office, if he lasts that long).

And the better choice is clear. Private for-profit insurers spend a fortune trying to attract healthy people while avoiding the sick and needy, filling out paperwork from hospitals and providers, paying top executives, and rewarding shareholders.

And for-profit insurers are merging like mad, in order to make even more money.

These are among the major reasons why health insurance is becoming so expensive, and why almost every other advanced nation – including our neighbor to the north – has adopted a single-payer system at less cost per person and with better health outcomes.

Surgical Tech Melissa Ellis prepares an OR room in the University of Mississippi Medical Center in Jackson, Mississippi October 4, 2013. Mississippi is one of at least 20 states that has decided not to expand Medicaid under the Affordable Care Act, known as "Obamacare". Jonathan Bachman/reuters

Most Americans support Medicare for All. According to a Gallup poll conducted in May, a majority would like to see a single-payer system implemented. An April survey from the Economist/YouGov showed 60 percent of Americans in favor of “expanding Medicare to provide health insurance to every American.”

That includes nearly half of people who identify themselves as Republican.

If Republicans gut the Affordable Care Act, the American public will be presented with the real choice ahead: Either expensive health care for the few, or affordable health care for the many.

Robert Reich is the chancellor’s professor of public policy at the University of California, Berkeley, and a senior fellow at the Blum Center for Developing Economies. He served as secretary of labor in the Clinton administration, and Time magazine named him one of the 10 most effective Cabinet secretaries of the 20th century. He has written 14 books, including the best-sellers Aftershock, The Work of Nations and Beyond Outrage and, most recently, Saving Capitalism. He is also a founding editor of The American Prospect magazine, chairman of Common Cause, a member of the American Academy of Arts and Sciences and co-creator of the award-winning documentary Inequality for All.